Reaching out to residents

This blog by Helen Henderson, Head of Reablement, Therapy and Community Services at Wiltshire Council, was first published in The MJ (opens new window) in January 2024.

Wiltshire has one of the country’s fastest growing older populations. Nearly 22% of everyone living here is 65 or over (opens new window): the average in England is 18.6%. We are also one of three councils in the Southwest with an older population that grew by more than 30% in the last decade (opens new window).

Residents living longer is wonderful news. But we also want to ensure they spend their later years in good health, doing the things they love, in the places they call home.

Unfortunately, that isn’t always the case. Many older people in our county have disabling illnesses or injuries that mean they can’t lead the life they want.

My team at Wiltshire Council was set up five years ago to tackle this. We provide support so individuals can achieve what’s important to them after being in hospital, having a fall or illness. That often means re-learning skills like cooking meals, managing their personal care or living independently doing things that are important to them.

The short-term, intensive support we provide is in demand. Since we established our reablement service in 2018, annual referrals have tripled to 3,340. This growing need, combined with Wiltshire’s rurality has forced us to think creatively about how we deliver support going forward.

One measure we’ve put in place is integrating digital, in its many forms, into our care. Staff now have many more options in their ‘toolbox’, helping them to design engaging and imaginative care programmes personalised to people’s ambitions.

Delivering digital reablement has not been without its challenges, though, and I’m keen to share my learning with local authorities facing similar demographic and geographical demands.

Blend in-person and remote support

Our service relies on the influence of occupational therapists and reablement workers to improve people’s physical ability and wellbeing.

That’s great when a staff member visits, but we often find people’s confidence dips when they’re alone again. To provide ongoing reassurance, we now combine face-to-face visits with remote monitoring, data analysis and online positive reinforcement.

That might be putting an exercise regime on someone’s tablet via an app and backing this up with reminders from a smart speaker.

Or it could be a home sensor system that learns a person’s daily routine and flags issues, such as them taking longer to move from sofa, to bathroom, to bed at night. We use this data to offer the right support, whether that’s referring to health providers or voluntary sector organisations or changing our own interventions.

Co-produce, co-produce, co-produce

Sharing decision making with people who draw on reablement is hugely important. This is true for any type of support, but it’s crucial if you’re incorporating technology into someone’s care package.

We’ve seen this first hand with residents at Dairy View, one of our extra care schemes managed by Housing 21. Through the TAPPI programme (Technology for our Ageing Population: Panel for Innovation) an occupational therapist worked with residents to explore how devices and apps could help them feel safer and more independent.

TAPPI, which is funded by Dunhill Medical Trust and led by the Housing Learning and Improvement Network (LIN) and the TEC Services Association (TSA), is all about improving how TEC (technology enabled care) is used in care and housing. We learnt that residents are much more likely to use digital devices or systems on an ongoing basis if they are involved in the decision-making from the start.

Improve connectivity

It sounds obvious, but having a reliable, secure internet connection is vital. Poor network coverage is common in rural Wiltshire and this, plus many older people not having wi-fi installed or being unable to afford it, can increase digital inequalities. Get the connectivity basics right before your team procures any TEC or tries to implement any packages dependent on assistive devices.

Connectivity also extends to different bits of kit working together. Reablement exercise apps don’t always talk to fall detectors, monitoring systems, GPS trackers and other devices. It’s worth thinking about how you can find systems that work together seamlessly.

Put training in place

Another contributor to digital inequality is literacy, or lack of it. Some residents have never had an

internet connection or mobile phone before and don’t know how it works. They are nervous about online security and privacy and worry that TEC might take carers away.

At Dairy View, we offered face-to-face sessions with a charity that supports people to use technology. This had a really positive impact on both people’s uptake and continued engagement with devices and we’re now looking to offer similar training to relatives and care workers.

Technology is transforming reablement delivery across Wiltshire and helping us achieve good outcomes. Between 2022-23, 78% of people were still in their home three months after drawing on reablement support – a figure we’re looking to improve in 2024.

The lessons we’ve learnt are now being used to reach people before they reach us. The council is raising awareness of technology enabled care through proactive demonstration and education sessions in local communities. It feels like the core role of technology in supporting people to live the lives they want is finally being recognised.

If you would like to find out more about Wiltshire Council's involvement in the TAPPI project as one of the 6 testbeds, visit: https://www.housinglin.org.uk/Topics/browse/Design-building/tappi/tappi2/

For further information about the use of technology to help reduce loneliness and isolation visit: https://www.housinglin.org.uk/Topics/browse/loneliness-and-isolation/assistive-technology/